Traumatic Brain Injury (TBI) is the leading cause of both death and disability for children and youth in the U.S and fully half of the estimated 5,300,000 persons in the U.S. who have TBI are under the age of 18. Each year, approximately 3,000 children die from traumatic brain injury and 29,000 of them survive injuries in the moderate to severe range. Approximately 30,000 chUdren acquire permanent disabilities annually due to TBI, with significant impact on their physical, cognitive, and psychosocial competencies. An estimated additional 900,000 children have "mild" TBIs each year, and the impact of these injuries on development and learning is largely unknown, but potentially significant. Concussions sustained in recreational and school sports are a notable source of mild TBI in children and adolescents. For example, national survey data estimate that 20% of high school football players receive a concussion each year. The University of Colorado Health Sciences Center (UCHSC) and The Children's Hospital, Denver (TCH), propose this major investigation of Traumatic Brain Injury (TBI) in children and adolescents. The primary aim of this research is a comprehensive, longitudinal study of the co.urse of mild, moderate, or severe TBI, from initial injury through long-term community reintegration. This project will establish a comprehensive database of variables related to psychosocial outcomes of TBI in children and youth and interventions that may improve these outcomes. Specific research objectives address the priority areas identified by the National Center for Injury Prevention and Control (NCIPC). A randomized, controlled comparison of four interventions for their impact on long-range psychosocial outcomes is planned. Collaboration between the UCHSC and the Colorado Department of Health's Programs for Children with Special Healthcare Needs (HCP) is an integral part of this proposal; this project has potential national significance as a model for community-based support of children and adolescents who sustain TBI.